NPIMap

Organization Active NPI

Manet Community Health Center, Inc.

Doing business as Manet Community Health Center, Inc. at Hull

  • Federally Qualified Health Center (FQHC)
  • Hull, MA
National Provider Identifier
1285665018
Registry record updated Mar 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
4801 Issued in MA
Legal business name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
Manet Community Health Center, Inc. at Hull
Practice address
180 George Washington Blvd
Hull, MA 02045-3069
Phone
(781) 925-4550
Fax
(781) 925-5052
NPI assigned
Jul 6, 2006
Last updated
Mar 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Cynthia Sierra
Title
Chief Executive Officer
Phone
(617) 404-4101

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 4801 MA Primary

Addresses

Primary practice location

180 George Washington Blvd
Hull, MA 02045-3069

Mailing address

110 W Squantum St
North Quincy, MA 02171-2122
Phone (617) 376-3030

Other names 1

  • Manet Community Health Center, Inc. at Hull Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20101102000926 MA Part A Provider - Federally Qualified Health Center (FQHC) 4486555158 Practice locations: Hull, MA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1285665018. Details of each certification follow.

Federally qualified health center certification: CCN 221866

Legal name
MANET COMMUNITY HEALTH CENTER, INC.
Doing business as
MANET COMMUNITY HEALTH CENTER AT HULL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Mar 16, 2005
Last certification
Mar 16, 2005
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Apr 5, 1978 in MA
Enrollment address
180 George Washington Blvd
Hull, MA 20453069

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Manet Community Health Center Inc13 organizations share this tax ID, including this one

Other organizations with this tax ID 12

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Cynthia Sierra Individual Corporate OfficerChief Executive Officer Jan 1, 2016 100%
Samantha Chen Individual Corporate DirectorBoard Member Jan 15, 2019 75%
Lisa J Levine Individual W-2 Managing EmployeeSenior Director Mar 18, 2014
Neda Hovaizi Individual Corporate DirectorBoard Member Jan 15, 2019 75%
Lawrence Flanagan Individual Corporate DirectorBoard Member Feb 21, 2017 75%
Mary Benvenuto Individual Corporate OfficerChief Financial Officer Jan 21, 2020 50%
Stephen Keches Individual Corporate DirectorBoard Member Jan 16, 2018 75%
John D Brothers Individual Corporate DirectorBoard Member Dec 5, 2000
Joseph M Reardon Individual Corporate DirectorBoard Member May 1, 2007
Robert Griffin Individual Corporate DirectorBoard Member Jan 24, 2011
John Galluzzo Individual Corporate DirectorBoard Member Jan 24, 2011
Lavinia M Roosa Individual Operational/Managerial ControlDirector of Revenue Mar 5, 2001 50%
Ivan S Wong Individual Corporate DirectorBoard Member Oct 20, 2009
Linda a Kelly Individual Corporate DirectorBoard Member May 6, 2006
Anne Bisson Individual Corporate DirectorBoard Member Nov 15, 2016 75%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1677801600000",
    "number": "1285665018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 W SQUANTUM ST",
            "city": "NORTH QUINCY",
            "state": "MA",
            "postal_code": "021712122",
            "telephone_number": "617-376-3030",
            "fax_number": "617-774-1906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 GEORGE WASHINGTON BLVD",
            "city": "HULL",
            "state": "MA",
            "postal_code": "020453069",
            "telephone_number": "781-925-4550",
            "fax_number": "781-925-5052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MANET COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A",
        "authorized_official_last_name": "SIERRA",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "617-404-4101"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "MA",
            "license": "4801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Manet Community Health Center, Inc. at Hull",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Manet Community Health Center, Inc. at Hull",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hull, MA

Sources for this page

Verify at the official NPI Registry.